[Relationship between initial archwire materials and pain at the initial stage of orthodontic treatment: a systematic review and network Meta-analysis]

Abstract

Objective: This review aims to assess the relationship between initial archwire materials and pain at the initial stage of orthodontic treatment.

Methods: On October 1, 2017, seven databases were searched electronically for studies oninitial archwire materials and pain at the initial stage of orthodontic treatment. Quality assessment was performed with bias risk assessment tools suggested by Cochrane's handbook. Data extraction of included studies was also carried out. Network Meta- analysis was conducted using R 3.4.2 (with JAGS 4.3.0), GeMTC 0.14.3, and STATA 11.0.

Results: Five studies with 330 participants were included, comparing four different materials: multi-stranded stainless steel, conventional nickel-titanium, super-elastic nickel-titanium, and thermal heat-activated nickel-titanium. Two studies were at low risk of bias, one was at high risk of bias, and the remaining two were at unclear risk of bias. Network Meta-analysis results showed no statistical differences of pain among the four initial archwire materials at day 1 and day 7. However, the most painless material was most likely to be thermal heat-activated nickel-titanium on rank probability.

Conclusions: On statistical probability, thermal heat-activated nickel-titanium initial arch wires is most likely to cause the least pain at the initial stage of orthodontic treatment, compared with other materials.

Keywords: dental alloys; network Meta-analysis; orthodontic wires; pain; systematic review.

图 1. 偏倚风险评估

Fig 1 Bias risk assessment 1~7分别为：随机方法、分配隐藏、实施盲法、测量盲法、数据完整、选择报道、其他偏倚。

图 2. 各研究间的网状关系

Fig 2 Network plot between the studies

图 3. 森林图

Fig 3 Forest plot

图 4. 排秩概率

Fig 4 Rank probability